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Old 11-13-2008, 11:42 AM #1
MYACHINGNECK1 MYACHINGNECK1 is offline
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MYACHINGNECK1 MYACHINGNECK1 is offline
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Help Still trying to find my way!! Help

received letter from workman comp ins. co to go for IME. well IME doctor said i am totally disabled from my current job and partially disabled from any other type of work. this doctor also stated i have had no treatment prior to and since my surgery (ACDF march 2008) and it would be resonable and that I would benefit from PT, etc.since i have never had any type of treatment but the surgery itself. also need a CT to confirm possible failed fusion.
This is very rare for an IME doctor to go on your side and against the ins. co. but if the MRI (recent one 10-30-08 shows 3 herniated cervical discs and scar tissue) and evidence is there the IME doctors have no choice.
my situation is that my own doctor tells me nothing will help me and that i should find another job as well my doctors told the ins. co that. so subsequently, in the last week i have been terminated by WC and all benefits will stop next week. also if i dont report to work next week i am fired.
what can i do when my own docs have refused to further treat me and the WC comp doc states i am disabled?
i have called other neurosurgons but unfortunately i cant get in to see them until feb 09. and at that time i wont have any ins. to pay nor $.
i do have an attorney on the case and he is preparing for the concilation meeting at DIA in a few weeks. but he is totally blown away. possibly never seen this type of case before .
please if anyone has any insight or comments, i am at a true loss because i really want to go back to work. i feel everything is slipping away from me. WC doc reported i am disabled and have on going symtoms and all are work related from my injury. and my docs won't write the note i am 100% or that all /any of my symtoms are gone in 4 weeks.
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Old 11-13-2008, 01:57 PM #2
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Wow that is a rare occurrence.
i had one IME dr say something favorable for my case and the next time wc sent me to a different IME that of course denied any work causation..

I am surprised your atty is baffled though..
I think the fact that your dr isn't agreeing with or backing up the IME dr is kind of odd.
Can you get another Independent drs opinion?

[terminated by WC and all benefits will stop next week]

You're saying the claim is denied? You/atty can appeal that decision right now, I think with just filing the paper for that.
{I don't know what a DIA is}
Has your dr released you for full work duties?
Or is employer taking you back with modified duties?

Mine was a chronic Repetitive strain injury it was denied, atty appealed and while the appeal was active I could still see PT & Drs and the bills were put on hold til it was settled. A letter by atty was all that was needed for the bills to be on hold.
And the employer cannot terminate you or medical ins while appeal is going either.
At least that how I understand it.
I didn't think my atty was the best but he did know about this stuff.
Your atty hasn't mentioned appeals and such- I hope he wasn't planning for a easy win and now isn't prepared.
He hasn't mentioned finding another dr for your treatment?? I can't believe any dr wouldn't at least suggest trying some PT...
Even if for only pain reduction.

Most states you can change drs and even attys but you'll have to look up on your state website for details of how to do that.
If you are denied , you need to get the appeal papers sent with in a certain time frame. That is the first thing to do, unless atty has some other plan...
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Old 11-14-2008, 12:21 PM #3
MYACHINGNECK1 MYACHINGNECK1 is offline
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Help still trying to find my way

work will terminate me due to the fact that neurosurgon says he cant explain all my symptoms. lawyer has filed with DIA(Department of industrial accidents) for a conciliation meeting. lawyer was blown away with the fact for the last year this was an accepted workman comp case. and know neurosurgon says surgery looks good and IME doctor says no, need CT this is failed fusion. so the two neurosurgons totally disagree and ins. co is terminating all benefits and i lost job so dont have health ins. right know. i was not released to work and the only note my current neurosurgon wrote is out of work to reavaluated by his colleage a psy doc. he feels all my sx. are psy related. i know this story is hard to believe but it is true. i have sent all my MRI'S to institutes to get free evaluations of MRI as well insight to what i can do for further treatment. nearest appointment i can get isnt until march next year.
i am so frustrated with my neuro. to turn this into a psy issue is ........ and refuse to order a CT , even if he does it to entertain me to prove psy issue. he wont do it. WHY, i dont know i have asked repeatedly and denied. it seems to me he is more concerned about protecting his reputation instead of listening to his pt. and the recommendations of IME doctor.
i am seeing a dr. know who will work with me and i am using my savings to pay him. he is also requesting a CT due to he felt something in my neck that was not normal in the surgical site area. so the dr. told me i need CT ASAP and he will make some calls. i am not sure if claims are still open or not while under appeal i am just paying dont know what else to do.

Quote:
Originally Posted by Jo55 View Post
Wow that is a rare occurrence.
i had one IME dr say something favorable for my case and the next time wc sent me to a different IME that of course denied any work causation..

I am surprised your atty is baffled though..
I think the fact that your dr isn't agreeing with or backing up the IME dr is kind of odd.
Can you get another Independent drs opinion?

[terminated by WC and all benefits will stop next week]

You're saying the claim is denied? You/atty can appeal that decision right now, I think with just filing the paper for that.
{I don't know what a DIA is}
Has your dr released you for full work duties?
Or is employer taking you back with modified duties?

Mine was a chronic Repetitive strain injury it was denied, atty appealed and while the appeal was active I could still see PT & Drs and the bills were put on hold til it was settled. A letter by atty was all that was needed for the bills to be on hold.
And the employer cannot terminate you or medical ins while appeal is going either.
At least that how I understand it.
I didn't think my atty was the best but he did know about this stuff.
Your atty hasn't mentioned appeals and such- I hope he wasn't planning for a easy win and now isn't prepared.
He hasn't mentioned finding another dr for your treatment?? I can't believe any dr wouldn't at least suggest trying some PT...
Even if for only pain reduction.

Most states you can change drs and even attys but you'll have to look up on your state website for details of how to do that.
If you are denied , you need to get the appeal papers sent with in a certain time frame. That is the first thing to do, unless atty has some other plan...
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Old 11-14-2008, 01:15 PM #4
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I thought, as long as you have an active wc claim or appeal going, you can't be terminated from employment...
Your atty should be able to help you somehow on that part of it.

Ah,
So your treating dr that is not helping you much was the one that did the fusion?? If so, he doesn't want to accept that something might have went wrong... I would not keep going to him either.
Your atty should be able to help you do a change of dr form.

But I also don't think wc can terminate you {meaning close your claim??}
if you have the appeal in process.
I'm far from an expert though.
during appeal your wc payments and such do get put on hold.. it's why they call it the "starve out" method.

Hopefully you have some way to get by.

did you look through our useful stickys, there might be something there with info that will help your situation.
http://neurotalk.psychcentral.com/thread1117.html
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Old 11-15-2008, 01:29 PM #5
MYACHINGNECK1 MYACHINGNECK1 is offline
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Help

thank you for your support. when i tell this story to most people they give me a look of disbelief. WHY WHY WHY i dont think i will ever know.
i want to share these web sites i found first is the bonati institute awesome source of information and the services they offer are amazing free MRI review and treatments available.
second is an actual product i am using now and i find it helps sooooooooo much!!! sombra-natural pain relieving gel
i am starting to accept the fact that i may have to live with chronic pain, and things have changed. this is a great web site and i want to thank you so much for being part of it. i have spent alot of time trying to prove i have medical issues and that it was not all in my head. now that i do have other doctors supporting me i need to let go and heal. it is sad that we are labled for so many things and have to be put in these postions to prove pain.
i am very fortunate that i have a great husband who has supported me from the begining. i will face some hard times but i will not "starve". i feel so sorry to my husband for having to deal with this as well my children it isnt fair to them i was hurt by a patient and it is wrong to them to have to deal with doctors arrogant elevated ego's.

"Adversity is the stone in which i sharpen my blade."
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